| Attentional Abilities | Mostly | Sometimes | Never |
| Completes classroom assignments during class time | _______ | _______ | _______ |
| Prepares for assigned activities (test, quiz, reading assignment) | _______ | _______ | _______ |
| Uses age appropriate organizational skills | _______ | _______ | _______ |
| Is able to give specific details when asked for an explanation or description | _______ | _______ | _______ |
| Understands nonverbal cues | _______ | _______ | _______ |
| Follows the course of a conversation | _______ | _______ | _______ |
| Follows directions from teachers and other school personnel | _______ | _______ | _______ |
| Thinks before acting | _______ | _______ | _______ |
| Knows how and when to initiate appropriate actions | _______ | _______ | _______ |
| Responds appropriately to the stimulation of the classroom | _______ | _______ | _______ |
| Able to stay on topic during a discussion | _______ | _______ | _______ |
| Can self-regulate behaviour in a classroom setting | _______ | _______ | _______ |
| | | |
| Cause/Effect Linking | _______ | _______ | _______ |
| Demonstrates concern about classroom performance | _______ | _______ | _______ |
| Demonstrates age-appropriate ability to take another’s point of view | _______ | _______ | _______ |
| Can articulate the implications of an action before undertaking it | _______ | _______ | _______ |
| Understands consequences and what they are for | _______ | _______ | _______ |
| Is able to change behaviour as result of consequences | _______ | _______ | _______ |
| Is able to generalize from the behaviour in one setting to the same or similar behaviour in
another setting | _______ | _______ | _______ |
| | | |
| Social Skills | Mostly | Sometimes | Never |
| Follows the school’s rules | _______ | _______ | _______ |
| Follows the classroom’s rules | _______ | _______ | _______ |
| Demonstrates age-appropriate self-control | _______ | _______ | _______ |
| Exercises good judgment in decision-making and behaviour | _______ | _______ | _______ |
| Can take responsibility for actions | _______ | _______ | _______ |
| Is able to wait for a turn to speak or to do something | _______ | _______ | _______ |
| Is able to share possessions or materials appropriately | _______ | _______ | _______ |
| Able to make and keep friendships | _______ | _______ | _______ |
| Normally associates with age-appropriate peers | _______ | _______ | _______ |
| Responds appropriately to redirection in an academic situation | _______ | _______ | _______ |
| Responds appropriately to redirection in a social situation | _______ | _______ | _______ |
| Demonstrates appropriate emotional response to a given situation | _______ | _______ | _______ |
| | | |
| Personal Skills | _______ | _______ | _______ |
| Interacts appropriately with the teacher on an instructional level | _______ | _______ | _______ |
| Reacts appropriately to praise and recognition | _______ | _______ | _______ |
| Reacts appropriately to constructive criticism | _______ | _______ | _______ |
| Responds appropriately to environmental cues | _______ | _______ | _______ |
| Takes responsibility for own actions | _______ | _______ | _______ |
| Adapts to increases in noise and stress | _______ | _______ | _______ |
| Appropriately responds to pressure | _______ | _______ | _______ |
| Responds appropriately to changes in task or assignment | _______ | _______ | _______ |
| Is able to accept changes in established routines | _______ | _______ | _______ |
| Adaptable to changes in physical environment, routines, transitions | _______ | _______ | _______ |
| Adaptable to changes in emotional environment, routines, transitions | _______ | _______ | _______ |
